关键词: 子痫前期, 胎盘生长因子, 妊娠相关蛋白A, 平均动脉压, 子宫动脉搏动指数

Abstract: Objective To explore the predictive effect of early pregnancy placental growth factor （PlGF） combined with pregnancy associated protein A（PAPP-A）, mean arterial pressure（MAP）and uterine artery pulsatility index（UtPI）on preeclampsia,and to analyze the positive rate,incidence rate and efficiency of screening, so as to provide some data basis for the clinical application of preeclampsia screening in Anhui Province. Methods From 2019 to 2021, six hospitals in Anhui Province were organized to carry out a multi center research project to collect the clinical information of pregnant women who met the enrollment criteria within 11~13⁺⁶ gestational weeks. PlGF and PAPP-A were detected by time-resolved fluoroimmunoassay. The eclampsia risk assessment software was used to calculate the combined risk of multiple indicators in combination with maternal factors,PlGF,PAPP-A,MAP and UtPI,and to track the pregnancy development and pregnancy outcome of pregnant women. The clinical application effect of this screening model was analyzed by data statistics.Results A total of 9 400 pregnant cases were collected. There were 243 pregnant women with pregnancy related hypertension,including 128 cases of preeclampsia,6 cases of chronic hypertension with preeclampsia,101 cases of gestational hypertension,and 8 cases of pregnancy with chronic hypertension. The incidence rate of preeclampsia was about 1.43%. The cases of chronic hypertension with preeclampsia,gestational hypertension and pregnancy with chronic hypertension were excluded,and the remaining 9 285 pregnant women were included in this study. 128 cases of preeclampsia were taken as the study group,and the other 9 157 cases were taken as the control group. The results showed that PAPP-A and PlGF in the study group were lower than those in the control group （P<0.05）,and MAP and UtPI were higher than those in the control group（P<0.05）. A total of 6 139 samples with complete quadruple indicators （PlGF+PAPP-A+MAP+UtPI） were collected for separate statistical analysis. When the cut-off value was 1/137,the false positive rate of PlGF+PAPP-A+MAP+UtPI quadruple screening scheme was 15%,and the positive rates of PE<32 weeks, PE<34 weeks and PE<37 weeks were 1.16%,3.31% and 15.08% respectively,and the detection rates were 90%,80% and 63.64% respectively.Conclusion PlGF combined with PAPP-A,MAP and UtPI in early pregnancy is of high value in predicting early-onset preeclampsia.

Key words: Preeclampsia, Placental growth factor, Pregnancy associated protein A, Mean arterial pressure, Uterine artery pulsatility index